The Importance of Dental Health in Long Term Care

In the field of long term care, we’re always looking for ways to improve the experience of the residents, patients, and families served by senior service organizations. Many times, there are aspects of everyday care that get overlooked, and over the life span we notice the consequences of neglecting those areas. Dr. Sanjay Gupta through the course of focus groups of aging adults (2016), discovered that dental health was one of the top areas they wished they had given more attention to during their lifetime.

One of these aspects that focused on recently has been dental care for elders. In the grand scheme of long term care, it may seem like a relatively insignificant part of a patient’s plan. However, a lack of quality dental hygiene for residents can seriously affect their overall health and impact their quality of life. Poor oral health can lead to weight loss, increased behaviors, pain, and poor nutrition. Many of the medications taken by elders can increase the problem of poor dental hygiene. CMS has also begun to focus on this problem through the recent issuance of The Final Rule for skilled settings.

For example, periodontal disease (a severe infection of the gums and jawbone) results from a lack of cleaning not just of the teeth, but of the gums, tongue, and cheeks and can develop easily in the elderly. The risk of aspiration pneumonia, a killer of older adults, is enhanced when dental caries, cavities, and periodontal disease combined with swallowing problems in older adults.

Catching dental problems before they develop is difficult for nursing staff in their average day. Although checking for signs of pain and infection is part of a nurse’s routine, these checks are not done often enough.  During bathing, dressing, and grooming, the mouth and throat certainly aren’t checked regularly to their full extent. Even with the best training, mouths are difficult to assess and have many spaces invisible to the eye when viewed from the front during brushing or flossing—especially concerning when you consider that seniors are at a higher risk for oral cancer than all other age groups.

Several other external factors contribute to this issue. Most nurses, nursing assistants and home health aides are under-trained on proper oral care and its importance, often prepared more for denture care than permanent teeth. Therefore, thorough brushing and flossing isn’t prioritized as a daily necessity but as a kind of luxury based on available time from assistants, which typically are getting less and less time for individual care due to the general staff shortage in long term care.

To fix this chain of issues, oral care for seniors must transcend the limitations of existing care plans and provide person-centered care.

For more great information and resources on oral health and care for seniors visit

Dr. Linda Shell, MA. RN |

Dr. Linda Shell MA, RN, principal and co-owner of LindaShell.Com and Legacy Market Services, Inc, has over twenty-five years of experience providing education, leadership development and consultation to non-profit and for-profit senior care organizations.

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